Valley fever, mimicker of malignancy

Area of Science:

• Mycology
• Infectious Diseases
• Epidemiology

Background:

• Coccidioidomycosis (Valley Fever) rates are rising in California and Arizona.
• Pulmonary involvement is most common, but disseminated disease affects ~1% of cases.
• Diagnosis is challenging in non-endemic areas due to mimicry of other conditions.

Observation:

• A previously healthy individual presented with severe disseminated coccidioidomycosis.
• Involvement included soft tissue, bone, and intra-abdominal organs.
• Initial diagnosis was suspected malignancy.

Findings:

• The case demonstrates a severe, multi-organ presentation of disseminated coccidioidomycosis.
• Coccidioides infection can present atypically, mimicking other serious diseases.
• Delayed diagnosis occurred due to initial misdiagnosis.

Implications:

• Climate change may expand Coccidioides geographical range.
• Healthcare providers need heightened awareness of coccidioidomycosis presentations.
• Maintaining a broad differential diagnosis is crucial for timely and appropriate treatment.